Refining the Concept of Lupus-associated Nociplasticity: A Proposal to Subdivide Type 2 SLE Based on Therapeutic Response

Fibromyalgia-like symptoms occur commonly in patients with Systemic Lupus Erythematosus. In 2019, it was proposed that symptoms of Lupus should be characterized as Type 1 and Type 2. Type 1 symptoms such as arthritis, serositis and nephritis are responsive to immunomodulatory treatments and Type 2 symptoms such as fatigue, widespread pain, poor sleep and headache do not respond to anti-inflammatory and immunosuppressive medications.[1] We propose that Type 2 symptoms be subclassified into type 2a and Type 2b as some Type 2 symptoms also respond to immunomodulatory and anti-inflammatory therapies.